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The Association of Smartphones, Back Pain in Adolescents, and Sitting Posture

For many of us, smartphones have become as essential as shoes. This greater connectivity seems to come with some orthopaedic drawbacks. You may have heard the term “text neck.”

Smartphone use is known to lead to tense neck-flexion angles resulting in muscle fatigue and neck pain.1 But what about back pain? It turns out there is a connection there, too.

In August, the International Journal of Environmental Research and Public Health published a study concerning smartphone use in adolescents and its effect on the upper spine.2 Researchers put 50 teens on adjustable height chairs for thirty minutes, but first gave them proper sitting instructions. Half had pre-existing back pain, and all had their smartphones. Researchers observed that the longer the teens used their phones, the more their posture slumped. Specifically, they measured the decrease in thoracic kyphosis (the natural, weight-distributing curvature of the upper spine). Both teens with and without back pain slumped, but the teens with a history of back pain slumped more. There was a statistically significant correlation between the degree of postural distortion with phone use and the history of back pain.

This data has the classic chicken-or-egg problem. Adolescents with back pain are known to have reduced proprioception and less trunk-muscle endurance.3,4  The structure of the current study cannot answer which comes first. Does hunkering over your phone cause back pain or does back pain cause adolescents to hunker over their phones? Regardless, it may be safe to assume the cell-phone posture/back pain connection is a self-reinforcing cycle. The simple answer is to be cognizant of posture when getting focused on a smartphone for an extended period, the same as you would at a work desk. Staying upright, shoulders back, and head forward is the most relaxed position for the spine.

For people already suffering from back pain, a simple reminder to sit up straight may not be enough help. A thorough exam and targeted reconditioning program can help. Call (02) 4954 5330 now, or contact us.  



  1. Namwongsa S, Puntumetakul R, Neubert MS, Boucaut R. Effect of neck flexion angles on neck muscle activity among smartphone users with and without neck pain. I. 2019 Dec 2;62(12):1524-33.
  2. In TS, Jung JH, Jung KS, Cho HY. Spinal and Pelvic Alignment of Sitting Posture Associated with Smartphone Use in Adolescents with Low Back Pain. International Journal of Environmental Research and Public Health. 2021 Jan;18(16):8369.
  3. Johnson OE, Mbada CE, Akosile CO, Agbeja OA. Isometric endurance of the back extensors in school-aged adolescents with and without low back pain. Journal of Back and Musculoskeletal Rehabilitation. 2009 Jan 1;22(4):205-11.
  4. O’Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D, Quirke H. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003 May 15;28(10):1074-9.


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